Evaluation of lipid-lowering therapy in patients with definite diagnosis of heterozygous familial hypercholesterolemia in Lodz

Abstract

Background and Aims : The aim of the study was to analyze a type and efficiency of lipid lowering therapy in patients with definite diagnosis of heFH. We also analyzed LDL corrected with Lp(a) and therapeutic LDL achievement in patients with familial hypercholesterolemia on optimal lipid-lowering therapy.Methods: We conducted retrospective analysis of 20 patients with definite clinical diagnosis of FH (DLCNS>8 score) and very high cardiovascular risk. We analyzed type of lipid lowering therapy (statin, ezetimibe, PCSK9i) baseline and 6 months follow up lipids including total cholesterol, LDL, HDL, non-HDL, Lp(a) and LDL corrected with Lp(a). LDL corrected with Lp(a) was calculated as LDL(corrected) = LDL [mg/dl] – 0,3 x Lp(a)Results: 20 patients enrolled in the study were 15 women and 5 men in mean age 50,65±15. Average baseline lipid parameters were: Total cholesterol: 321±93mg/dl ; LDL cholesterol 252,58±68mg/dl; HDL cholesterol 54,11±16; non-HDL cholesterol 250,14±116mg/dl; Triglycerides 160,55±112mg/dl; Lp(a) 90,34±111; LDL(corrected) 242,47±72mg/dl. All patients had definite diagnosis of familial hypercholesterolemia and mean DLCNS was 14,25±4. All patients had lipid lowering therapy introduced including high intensity statin (atorwastatin 3/20 patients in mean dose 60mg, rosuwastatin 17/20 in mean dose 27,06mg), ezetimibe 19/20 patients in dose 10mg and 14 patients were on PCSK9 inhibitors (6 on ewolocumab and 8 on alirocumab). After 6 months follow-up, mean lipid parameters were: Total cholesterol: 169,2±65mg/dl ; LDL cholesterol 94±50mg/dl; HDL cholesterol 45,64±8; non-HDL cholesterol 102,97±77mg/dl; Triglycerides 167,8±115mg/dl; Lp(a) 70,25±107; LDL(corrected) 87,33±49mg/dl.Conclusions: Despite optimal, intensive lipid-lowering therapy, the achievement of therapeutic LDL in patients with FH is not satisfactory. Background and Aims : The aim of the study was to analyze a type and efficiency of lipid lowering therapy in patients with definite diagnosis of heFH. We also analyzed LDL corrected with Lp(a) and therapeutic LDL achievement in patients with familial hypercholesterolemia on optimal lipid-lowering therapy. Methods: We conducted retrospective analysis of 20 patients with definite clinical diagnosis of FH (DLCNS>8 score) and very high cardiovascular risk. We analyzed type of lipid lowering therapy (statin, ezetimibe, PCSK9i) baseline and 6 months follow up lipids including total cholesterol, LDL, HDL, non-HDL, Lp(a) and LDL corrected with Lp(a). LDL corrected with Lp(a) was calculated as LDL(corrected) = LDL [mg/dl] – 0,3 x Lp(a) Results: 20 patients enrolled in the study were 15 women and 5 men in mean age 50,65±15. Average baseline lipid parameters were: Total cholesterol: 321±93mg/dl ; LDL cholesterol 252,58±68mg/dl; HDL cholesterol 54,11±16; non-HDL cholesterol 250,14±116mg/dl; Triglycerides 160,55±112mg/dl; Lp(a) 90,34±111; LDL(corrected) 242,47±72mg/dl. All patients had definite diagnosis of familial hypercholesterolemia and mean DLCNS was 14,25±4. All patients had lipid lowering therapy introduced including high intensity statin (atorwastatin 3/20 patients in mean dose 60mg, rosuwastatin 17/20 in mean dose 27,06mg), ezetimibe 19/20 patients in dose 10mg and 14 patients were on PCSK9 inhibitors (6 on ewolocumab and 8 on alirocumab). After 6 months follow-up, mean lipid parameters were: Total cholesterol: 169,2±65mg/dl ; LDL cholesterol 94±50mg/dl; HDL cholesterol 45,64±8; non-HDL cholesterol 102,97±77mg/dl; Triglycerides 167,8±115mg/dl; Lp(a) 70,25±107; LDL(corrected) 87,33±49mg/dl. Conclusions: Despite optimal, intensive lipid-lowering therapy, the achievement of therapeutic LDL in patients with FH is not satisfactory.